Does IR35 apply to every locum?

No. IR35 concerns work through an intermediary, usually a personal service company. Ordinary employment and direct sole-trader work have their own status rules.

Who decides my IR35 status?

For public-sector and medium or large private-sector clients, responsibility generally sits with the client. Different rules apply for small private-sector clients.

Can every locum use Forms A and B?

These forms concern eligible GP locum work; they are not a route to pension every hospital, agency or private engagement.

Clinical professionals

Locum doctor accountants: tax, IR35 and NHS pensions

Accountancy for locum doctors and GPs, from your first tax return to multiple agency engagements. Compare structures, review IR35 and plan for tax payments.

Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.

Fixed monthly fee — no surprises
Specialist in NHS pension and healthcare tax
Onboarding within 48 hours

Get my fixed-fee quote Book a free 15-min tax review

ICAEW & ACCA regulated
5,000+ clients served by ACCOTAX
Specialist healthcare accountants

Reviewed by Waqas Sagar ACA FCCA FMAAT · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year

Key takeaways

Your actual working arrangements determine the tax treatment; choosing a package does not change your employment status.
Keep records for each income source and check the official guidance linked to the questions below.
Agree the accounts, returns and advisory work you need before accepting a written fixed-fee quote.

Which accountancy support fits your income?

Start with how you are paid. Different income sources can need different accounts, returns and expense checks.

How you work	What we check	Support to explore
Employed or umbrella (PAYE)	Tax codes, eligible employment expenses and whether a tax return is needed.	Healthcare tax refund support
Genuinely self-employed	Business income and expenses, Self Assessment and MTD eligibility.	Healthcare Self Assessment service
Your own limited company	Company accounts, Corporation Tax, director income and off-payroll status where relevant.	Healthcare limited company accounts
Partnership	Practice accounts, allocated profit and each partner’s personal tax position.	Healthcare partnership accounts

Sound familiar?

Problems we fix for locum doctors

"I don't know if I should be a sole trader, a limited company or use an umbrella."
"A trust or agency has sent me an IR35 determination I don't understand."
"My first tax bill was huge because of payments on account."
"I keep missing or getting my locum A/B and Type 2 pension forms wrong."
"I spend hours chasing unpaid invoices."
"I'm not sure what I can claim — indemnity, GMC, mileage?"
"Making Tax Digital quarterly updates start from April 2026 and I'm not ready."

What it's costing you

Leaving it unfixed is rarely free

Overpaid tax: Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
HMRC penalties and interest: Late returns attract automatic penalties, plus interest on tax paid late.
Lost evenings: Hours spent on forms, invoices and spreadsheets after a long shift.

General examples — your position depends on your own figures.

How we solve it

What we actually do for you

Structure review

A take-home comparison of sole trader, limited company and umbrella for your shifts.

IR35 check

We review each Status Determination Statement and help you challenge it where justified.

Pension form management

We prepare and track your locum A/B and Type 2 forms.

MTD-ready bookkeeping

Quarterly updates handled with software set up for you.

How we help

First locum tax return

Identify when self-employment began, review HMRC registration and reconcile invoices, deductions and payments.

IR35 and contracts

Review the contract and actual working arrangements for each engagement, rather than relying on a company name.

Tax cash-flow planning

Estimate tax and payments on account, allowing for variable work and income already taxed through PAYE.

GP locum pension forms

Help reconcile eligible GP locum work and the information needed for NHS pension Forms A and B.

What to know before you decide

Limited company or sole trader?

A company is not automatically the most tax-efficient answer. Some engagements fall within the off-payroll rules, while an agency or umbrella may deduct PAYE before you are paid. Compare expected income, allowable costs, company running costs and pension access before choosing a structure. Hospital locum and GP locum arrangements are not interchangeable.

Limited Company Accounts & Corporation Tax for Doctors & Healthcare Professionals

Your first January bill can include next year’s tax

A first Self Assessment payment may include a balancing payment and a payment on account towards the following year. A second instalment can then follow in July. Whether payments on account apply depends on the tax due and how much was collected at source. Set aside cash using a forecast based on your actual mix of work, not a generic percentage.

Your questions answered

What documents do I need for my return?

You typically require P60s, P11D forms, interest certificates, and records of all business income and expenses. Medical.Accountants provides a tailored checklist based on your specific healthcare role. We will request these details during our onboarding process. Providing comprehensive documentation ensures your tax position is accurately calculated.

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What are payments on account?

Payments on account are advance payments towards your next Self Assessment bill, normally due on 31 January and 31 July. Each is usually half the previous year’s relevant Income Tax and Class 4 National Insurance bill, excluding Capital Gains Tax and student loans. Exceptions apply where the bill is below £1,000 or over 80% was collected at source.

Check the official guidance · www.gov.uk

Help with this question: Self Assessment Tax Returns for Doctors & Healthcare Professionals

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Can I amend a return after filing?

You can generally amend a Self Assessment return within 12 months of the 31 January filing deadline. This allows you to correct errors or include forgotten information. Medical.Accountants can assist in reviewing previous submissions to ensure accuracy. Tax refunds can be claimed for up to four previous tax years.

Check the official guidance · www.gov.uk Want us to check this for you? Get a free review →

Quick quote

See what you could save — get a fixed fee in one working day

Three fields. No obligation. A specialist replies, not a sales team.

Packages for your working life

Accountancy packages for locums

Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.

Self-employed accountants for locums packages

For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.

Sole-trader accounts and personal tax return
Allowable business expenses reviewed
Tax reserve and payment deadline guidance
MTD support scoped separately where required

Fixed fee quoted after a review

Discuss this package

Limited company accountants for locums packages

For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.

Statutory accounts and Corporation Tax return
One director return for salary and dividends from the same company
Confirmation statement support; filing fee extra
Bookkeeping, VAT and payroll according to your chosen plan

Company packages from £45.83 + VAT / month

Compare company packages

Personal tax return packages for locums

For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.

Self Assessment requirement checked
PAYE and other income reconciled
Eligible employment expenses reviewed
Pension tax work agreed separately where needed

Fixed fee quoted after a review

Discuss this package

Employment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.

Overpaid tax?

Tax refund support for locums

We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.

£249 + VAT

For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.

Example: a £6,000 refund means £249 + £50 = £299 plus VAT.

Illustrative refund amount (£)

Professional fee, excluding VAT

£249

Ask about a tax refund

This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.

What's included

Limited company packages — compare what's included

Essential/Compliance

For locums, salaried GPs and dentists with a limited company

from £45.83 + VAT /month

FRS 105 or FRS 102 1A statutory accounts
Corporation tax return (CT600) and tax computation
Confirmation statement preparation and filing support
One director Self Assessment return
Deadline reminders ahead of every filing date

Core/Complete

For private practice, consultants and associate dentists

from £62.50 + VAT /month

Everything in Essential/Compliance
Monthly bookkeeping and bank reconciliation
Quarterly Making Tax Digital VAT returns
Director payroll with RTI filing and pension submissions
Quarterly review call on numbers and tax position

Growth

For clinics, dental practices and growing medical teams

from £75.00 + VAT /month

Everything in Core/Complete
Payroll for up to five employees

Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees

Why clinicians trust us

Chartered accountants who know the NHS

ACCOTAX has served over 5,000 clients.
Regulated chartered accountants (ICAEW and ACCA).
Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.

Reviewed by Waqas Sagar ACA FCCA FMAAT

Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.

Get my fixed-fee quote

How it works

01
Free call
A 15-minute chat about your income, structure and deadlines.
02
Onboarding in 48 hours
We set up your records, software and HMRC agent access.
03
We handle the rest
HMRC, NHS Pensions and every deadline, with reminders before each one.

Free resource

Get the locum expenses checklist free

Tell us where to send it and we'll email it to you.

Your questions, answered

Does IR35 apply to every locum?: No. IR35 concerns work through an intermediary, usually a personal service company. Ordinary employment and direct sole-trader work have their own status rules.
Who decides my IR35 status?: For public-sector and medium or large private-sector clients, responsibility generally sits with the client. Different rules apply for small private-sector clients.
Can every locum use Forms A and B?: These forms concern eligible GP locum work; they are not a route to pension every hospital, agency or private engagement.

Speak to a specialist today

Leave your details and we'll call you back, or book a free review straight away.

Book a free 15-min tax review

Related healthcare expertise

IR35 Reviews for Doctors & Healthcare Professionals NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals Limited Company Accounts & Corporation Tax for Doctors & Healthcare Professionals Accountants for doctors and GPs in the UK NHS pension annual allowance accountants Self Assessment tax returns for doctors and healthcare staff

Accountants for healthcare professionals Healthcare tax questions answered

General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.

Official guidance

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